• 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院腫瘤外科（沈陽(yáng) 110001）;

目的  探討老年胃癌患者并存疾病的圍手術(shù)期處理方法。方法  回顧性分析我院于1980年3月至2008年11月期間收治的528例70歲及以上胃癌患者并存疾病圍手術(shù)期處理的臨床資料。結(jié)果  主要并存疾病為心血管疾?。?59例,49.05%）、呼吸系統(tǒng)疾?。?61例,30.49%）及糖尿?。?2例,13.64%），主要給予調(diào)整血壓、血糖及改善心、肺、肝、腎功能治療。術(shù)后常見并發(fā)癥為腸梗阻（10例）、肺部感染（10例）、返流性食管炎（9例）、殘胃功能性排空障礙（7例）及吻合口漏（5例）。圍手術(shù)期死亡10例，包括心肺功能衰竭6例、急性心肌梗死2例，吻合口漏1例及腸梗阻1例。結(jié)論  老年胃癌患者多并存高血壓、支氣管炎、糖尿病等疾病。術(shù)前全面了解病情，加強(qiáng)對(duì)并存疾病的圍手術(shù)期處理，不僅能降低手術(shù)的風(fēng)險(xiǎn)，而且能減少并發(fā)癥的發(fā)生率和降低圍手術(shù)期死亡率。

引用本文： 樊濤,戴冬秋,徐惠綿,鄧鵬,宋英杰. 老年胃癌患者并存疾病的圍手術(shù)期處理. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(12): 1017-1019,1024. doi: 復(fù)制

1. 陳峻青, 夏志明主編. 胃腸癌手術(shù)學(xué) [M]. 第2版. 北京： 人民衛(wèi)生出版社, 2008： 167.
2. Matsushita I, Hanai H, Kajimura M, et al. Should gastric cancer patients more than 80 years of age undergo surgery? Comparison with patients not treated surgically concerning prognosis and quality of life [J]. J Clin Gastroenterol, 2002; 35(1): 29-34.
3. 程愛群, 李翔, 朱捷, 等. 老年胃癌患者的外科治療和圍手術(shù)期處理 [J]. 中華胃腸外科雜志, 2004; 7(2): 130-133.
4. Walsh SR, Oates JE, Anderson JA, et al. Postoperative arrhythmias in colorectal surgical patients: incidence and clinical correlates [J]. Colorectal Dis, 2006; 8(3): 212-216.
5. 張廣平, 馮笑山, 陳登庭. 高齡胃癌患者臨床治療分析 [J]. 中國(guó)腫瘤臨床與康復(fù), 2003; 10(3): 250-251.
6. 陳娟, 管向東. 合并高血壓病人圍手術(shù)期處理 [J]. 中國(guó)實(shí)用外科雜志, 2008; 28(2): 102-104.
7. 喻田, 余志豪. 圍術(shù)期高血壓的發(fā)生與處理 [J]. 中華麻醉學(xué)雜志, 2002; 22(6): 382-384.
8. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies [J]. Lancet, 2002; 360(9349): 1903-1913.
9. 汪靜, 吳言濤. 合并原發(fā)性高血壓病行腹部手術(shù)患者術(shù)前準(zhǔn)備初探 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002; 9(2): 115-117.
10. Howell SJ, Sear JW, Fox P. Hypertension, hypertensive heart disease and perioperative cardiac risk [J]. Br J Anaesth, 2004; 92(4): 570-583.
11. Kanat F, Golcuk A, Teke T, et al. Risk factors for postoperative pulmonary complications in upper abdominal surgery [J]. ANZ J Surg, 2007; 77(3): 135-141.
12. 張偉, 趙高平, 楊春, 等. 胃腸道腫瘤合并糖尿病患者術(shù)后早期腸內(nèi)營(yíng)養(yǎng)支持及血糖控制 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008; 15(6): 444-447.
13. 翟剛, 李強(qiáng), 張計(jì)平. 老年胃癌患者圍手術(shù)期治療體會(huì) [J]. 腫瘤研究與臨床, 2003; 15(2): 115-116.
14. Gil-Rendo A, Hernández-Lizoain JL, Martínez-Regueira F, et al. Risk factors related to operative morbidity in patients undergoing gastrectomy for gastric cance [J]. Clin Transl Oncol, 2006; 8(5): 354-361.
15. Ichikawa D, Kurioka H, Yamaguchi T, et al. Postoperative complications following gastrectomy for gastric cancer during the last decade [J]. Hepatogastroenterology, 2004; 51(56): 613-617.
16. Kawasaki N, Suzuki Y, Nakayoshi T, et al. Early postoperative enteral nutrition is useful for recovering gastrointestinal motility and maintaining the nutritional status [J]. Surg Today, 2009; 39(3): 225-230.
  1. 1. 陳峻青, 夏志明主編. 胃腸癌手術(shù)學(xué) [M]. 第2版. 北京： 人民衛(wèi)生出版社, 2008： 167.
  2. 2. Matsushita I, Hanai H, Kajimura M, et al. Should gastric cancer patients more than 80 years of age undergo surgery? Comparison with patients not treated surgically concerning prognosis and quality of life [J]. J Clin Gastroenterol, 2002; 35(1): 29-34.
  3. 3. 程愛群, 李翔, 朱捷, 等. 老年胃癌患者的外科治療和圍手術(shù)期處理 [J]. 中華胃腸外科雜志, 2004; 7(2): 130-133.
  4. 4. Walsh SR, Oates JE, Anderson JA, et al. Postoperative arrhythmias in colorectal surgical patients: incidence and clinical correlates [J]. Colorectal Dis, 2006; 8(3): 212-216.
  5. 5. 張廣平, 馮笑山, 陳登庭. 高齡胃癌患者臨床治療分析 [J]. 中國(guó)腫瘤臨床與康復(fù), 2003; 10(3): 250-251.
  6. 6. 陳娟, 管向東. 合并高血壓病人圍手術(shù)期處理 [J]. 中國(guó)實(shí)用外科雜志, 2008; 28(2): 102-104.
  7. 7. 喻田, 余志豪. 圍術(shù)期高血壓的發(fā)生與處理 [J]. 中華麻醉學(xué)雜志, 2002; 22(6): 382-384.
  8. 8. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies [J]. Lancet, 2002; 360(9349): 1903-1913.
  9. 9. 汪靜, 吳言濤. 合并原發(fā)性高血壓病行腹部手術(shù)患者術(shù)前準(zhǔn)備初探 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2002; 9(2): 115-117.
  10. 10. Howell SJ, Sear JW, Fox P. Hypertension, hypertensive heart disease and perioperative cardiac risk [J]. Br J Anaesth, 2004; 92(4): 570-583.
  11. 11. Kanat F, Golcuk A, Teke T, et al. Risk factors for postoperative pulmonary complications in upper abdominal surgery [J]. ANZ J Surg, 2007; 77(3): 135-141.
  12. 12. 張偉, 趙高平, 楊春, 等. 胃腸道腫瘤合并糖尿病患者術(shù)后早期腸內(nèi)營(yíng)養(yǎng)支持及血糖控制 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008; 15(6): 444-447.
  13. 13. 翟剛, 李強(qiáng), 張計(jì)平. 老年胃癌患者圍手術(shù)期治療體會(huì) [J]. 腫瘤研究與臨床, 2003; 15(2): 115-116.
  14. 14. Gil-Rendo A, Hernández-Lizoain JL, Martínez-Regueira F, et al. Risk factors related to operative morbidity in patients undergoing gastrectomy for gastric cance [J]. Clin Transl Oncol, 2006; 8(5): 354-361.
  15. 15. Ichikawa D, Kurioka H, Yamaguchi T, et al. Postoperative complications following gastrectomy for gastric cancer during the last decade [J]. Hepatogastroenterology, 2004; 51(56): 613-617.
  16. 16. Kawasaki N, Suzuki Y, Nakayoshi T, et al. Early postoperative enteral nutrition is useful for recovering gastrointestinal motility and maintaining the nutritional status [J]. Surg Today, 2009; 39(3): 225-230.